Intergenerational disadvantage and pediatric health disparities in acute respiratory illness and diarrhea
This project seeks to document the frequency and duration of diarrheal disease and acute respiratory infection in early childhood, and assess how intergenerational disadvantage and household and community circumstances shape disparities in children’s health, illness, and healthcare utilization.
Grant Information
End Date: 04/30/2029
Open To: Doctoral Students, Post-Doctoral Fellows
Funding Source: National Institute of Child Health and Human Development (NICHD)
We invite post-doctoral fellows and UM doctoral students to work with us to develop their own research project using our project as a foundation.
Restrictions
Doctoral students must be currently enrolled at the University of Michigan
Post-doctoral fellows will need to relocate to the University of Michigan during the award period
Emily Treleaven
Dr. Treleaven studies the mechanisms through which family and community context shape health and health disparities in early childhood, and how health system characteristics affect children’s health and healthcare utilization. This includes how families make decisions and investments related to young children’s health, with particular interests in economic insecurity, migration, and gender. She also evaluates interventions related to maternal, newborn, and child health. Across her work, Dr. Treleaven is interested in developing and testing innovative survey measures and strategies to improve measurement of health and mortality in early childhood.
Global literature underscores that certain children and families are more likely to experience persistent social and economic disadvantages often determined by their race, ethnicity, social group, or other socio- demographic characteristics. Simultaneously, studies from diverse settings demonstrate unequal burdens of disease and unequal access to timely, quality health services in early childhood, contributing to lifelong health disparities. However, few studies have available data to examine the distinct ways that intergenerational disadvantage contributes to disparities in illness burden and healthcare utilization among children under five when morbidity and mortality risk are high. We address a critical gap in the research by estimating the association of persistent intergenerational disadvantage and diarrheal disease and acute respiratory infection (ARI), with attention to the role of persistent disadvantage in determining the likelihood and type of healthcare received, and potential modification by spatial remoteness. We use data from a longitudinal study of households that includes data on young children and their parents, households, and communities. The availability of detailed, high-frequency measures of the incidence and duration of diarrheal disease and ARI in combination with data on household and community context and health services over time provides a unique opportunity to study these questions with three specific aims. The first aim uses newly collected data about experiences of diarrheal disease and ARI among children under five years of age to estimate the association between persistent disadvantage and children’s illness burden. The second aim estimates the association between the burden of diarrheal disease and ARI and the likelihood and characteristics of healthcare utilized. This aim also tests whether this association is modified by persistent household disadvantage. The third aim investigates the roles of spatial remoteness, distance to health ser- vices, and persistent household disadvantage as modifiers of the association between the burden of diarrheal disease and ARI, and the likelihood and type of healthcare facility utilized. We will archive and disseminate all data collected to facilitate innovative research on social and structural determinants of child health and healthcare utilization outcomes, and inform child health and health equity programs globally. The effects of persistent, intergenerational social and economic disadvantage are increasingly important considerations for providers and policymakers seeking to improve children’s health and health service utilization, and to reduce health disparities that emerge in early childhood. This research will enhance our understanding of the mechanisms through which exposure to persistent disadvantage shapes the health and illness burden among young children; identify promising avenues for future research in this area; and generate rigorous evidence for effective child health policies and interventions.
acute respiratory infections, burden of disease, Child health, children under five, diarrhea, healthcare utilization, intergenerational disadvantage, neighborhood disadvantage, socioeconomic status
